MEDICARE: CUMBERLAND PHARMACY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	PH24780	FL
2	333600000X	Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073813309
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CUMBERLAND PHARMACY LLC

Provider Business Mailing Address
First Line	:	1047 W BUSCH BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-7703
Country	:	US
Telephone Number	:	813-991-7233
Fax Number	:	888-556-8496

Provider Business Practice Location Address
First Line	:	1047 W BUSCH BLVD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33612-7703
Country	:	US
Telephone Number	:	813-991-7233
Fax Number	:	813-991-7255

Authorized Official
Title or Position	:	PHARMACIST/OWNER/AUTHORIZED OFFICER
Name	:	DR. OSANEME CHUKA OKARO
Credential	:	PHARMD
Telephone Number	:	850-273-1344

Provider Enumeration Date	:	11/03/2010
Last Update Date	:	03/01/2021

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Directions to “CUMBERLAND PHARMACY LLC ” Practice Location

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